St. Barnabas Hospital

All Charges

Charge

Type

Price

BIOMET BIPOLAR LINER

Facility OP

$2,384.24

Service Code	HCPCS C1776
Hospital Charge Code	40024005
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,503.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,311.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,192.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,370.94
Rate for Payer: Fidelis Medicare Advantage	$2,503.45
Rate for Payer: Group Health Inc Commercial	$1,192.12
Rate for Payer: Group Health Inc Medicare	$834.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,192.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,192.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,549.76

BIOMET BIPOLAR LINER

Facility IP

$2,384.24

Service Code	HCPCS C1776
Hospital Charge Code	40024005
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.12
Max. Negotiated Rate	$1,192.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,192.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,192.12

BIOMET BUTTON BIOMET ARCOM

Facility IP

$1,314.00

Service Code	HCPCS C1713
Hospital Charge Code	40203369
Hospital Revenue Code	278
Min. Negotiated Rate	$657.00
Max. Negotiated Rate	$657.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$657.00
Rate for Payer: Hamaspik Choice Inc Medicare	$657.00

BIOMET BUTTON BIOMET ARCOM

Facility OP

$1,314.00

Hospital Charge Code	40009352
Hospital Revenue Code	272
Min. Negotiated Rate	$459.90
Max. Negotiated Rate	$1,051.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$722.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$657.00
Rate for Payer: Aetna Government	$657.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,051.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$893.52
Rate for Payer: Group Health Inc Commercial	$657.00
Rate for Payer: Group Health Inc Medicare	$459.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$657.00
Rate for Payer: Hamaspik Choice Inc Medicare	$657.00

BIOMET BUTTON BIOMET ARCOM

Facility OP

$1,314.00

Service Code	HCPCS C1713
Hospital Charge Code	40203369
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,379.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$722.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$657.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$755.55
Rate for Payer: Fidelis Medicare Advantage	$1,379.70
Rate for Payer: Group Health Inc Commercial	$657.00
Rate for Payer: Group Health Inc Medicare	$459.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$657.00
Rate for Payer: Hamaspik Choice Inc Medicare	$657.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$854.10

BIOMET C/BI METRIC POROUS STEM E

Facility IP

$8,534.00

Service Code	HCPCS C1713
Hospital Charge Code	40209588
Hospital Revenue Code	278
Min. Negotiated Rate	$4,267.00
Max. Negotiated Rate	$4,267.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,267.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,267.00

BIOMET C/BI METRIC POROUS STEM E

Facility OP

$8,534.00

Service Code	HCPCS C1713
Hospital Charge Code	40209588
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,960.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,693.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,267.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,907.05
Rate for Payer: Fidelis Medicare Advantage	$8,960.70
Rate for Payer: Group Health Inc Commercial	$4,267.00
Rate for Payer: Group Health Inc Medicare	$2,986.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,267.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,267.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,547.10

BIOMET CENTRALIZER SLEEVE

Facility OP

$340.20

Hospital Charge Code	40024001
Hospital Revenue Code	270
Min. Negotiated Rate	$119.07
Max. Negotiated Rate	$272.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$187.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$170.10
Rate for Payer: Aetna Government	$170.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$272.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$231.34
Rate for Payer: Group Health Inc Commercial	$170.10
Rate for Payer: Group Health Inc Medicare	$119.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.10
Rate for Payer: Hamaspik Choice Inc Medicare	$170.10

BIOMET CONSTRUX FIXATOR

Facility OP

$9,192.00

Hospital Charge Code	40205834
Hospital Revenue Code	279
Min. Negotiated Rate	$3,217.20
Max. Negotiated Rate	$7,353.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,055.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,596.00
Rate for Payer: Aetna Government	$4,596.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,353.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,250.56
Rate for Payer: Group Health Inc Commercial	$4,596.00
Rate for Payer: Group Health Inc Medicare	$3,217.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,596.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,596.00

BIOMET EP VANGUARD TIB/BEARING

Facility OP

$5,294.00

Service Code	HCPCS C1776
Hospital Charge Code	40205904
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,558.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,911.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,647.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,044.05
Rate for Payer: Fidelis Medicare Advantage	$5,558.70
Rate for Payer: Group Health Inc Commercial	$2,647.00
Rate for Payer: Group Health Inc Medicare	$1,852.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,647.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,647.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,441.10

BIOMET EP VANGUARD TIB/BEARING

Facility IP

$5,294.00

Service Code	HCPCS C1776
Hospital Charge Code	40205904
Hospital Revenue Code	278
Min. Negotiated Rate	$2,647.00
Max. Negotiated Rate	$2,647.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,647.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,647.00

BIOMET FEMALE ROTATOR ADAPTER

Facility OP

$1,476.00

Hospital Charge Code	40205832
Hospital Revenue Code	279
Min. Negotiated Rate	$516.60
Max. Negotiated Rate	$1,180.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$811.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$738.00
Rate for Payer: Aetna Government	$738.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,180.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,003.68
Rate for Payer: Group Health Inc Commercial	$738.00
Rate for Payer: Group Health Inc Medicare	$516.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$738.00
Rate for Payer: Hamaspik Choice Inc Medicare	$738.00

BIOMET FEMORAL COMP CEMENTED

Facility IP

$7,232.09

Service Code	HCPCS C1776
Hospital Charge Code	40024007
Hospital Revenue Code	278
Min. Negotiated Rate	$3,616.04
Max. Negotiated Rate	$3,616.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,616.04
Rate for Payer: Hamaspik Choice Inc Medicare	$3,616.04

BIOMET FEMORAL COMP CEMENTED

Facility OP

$7,232.09

Service Code	HCPCS C1776
Hospital Charge Code	40024007
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,593.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,977.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,616.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,158.45
Rate for Payer: Fidelis Medicare Advantage	$7,593.69
Rate for Payer: Group Health Inc Commercial	$3,616.04
Rate for Payer: Group Health Inc Medicare	$2,531.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,616.04
Rate for Payer: Hamaspik Choice Inc Medicare	$3,616.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,700.86

BIOMET FEMORAL COMP NON CEMENTED

Facility OP

$9,208.08

Service Code	HCPCS C1776
Hospital Charge Code	40024008
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,668.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,064.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,604.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,294.65
Rate for Payer: Fidelis Medicare Advantage	$9,668.48
Rate for Payer: Group Health Inc Commercial	$4,604.04
Rate for Payer: Group Health Inc Medicare	$3,222.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,604.04
Rate for Payer: Hamaspik Choice Inc Medicare	$4,604.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,985.25

BIOMET FEMORAL COMP NON CEMENTED

Facility IP

$9,208.08

Service Code	HCPCS C1776
Hospital Charge Code	40024008
Hospital Revenue Code	278
Min. Negotiated Rate	$4,604.04
Max. Negotiated Rate	$4,604.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,604.04
Rate for Payer: Hamaspik Choice Inc Medicare	$4,604.04

BIOMET FEMORAL HEAD

Facility IP

$1,669.82

Service Code	HCPCS C1776
Hospital Charge Code	40024004
Hospital Revenue Code	278
Min. Negotiated Rate	$834.91
Max. Negotiated Rate	$834.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$834.91
Rate for Payer: Hamaspik Choice Inc Medicare	$834.91

BIOMET FEMORAL HEAD

Facility OP

$1,669.82

Service Code	HCPCS C1776
Hospital Charge Code	40024004
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,753.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$918.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$834.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$960.15
Rate for Payer: Fidelis Medicare Advantage	$1,753.31
Rate for Payer: Group Health Inc Commercial	$834.91
Rate for Payer: Group Health Inc Medicare	$584.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$834.91
Rate for Payer: Hamaspik Choice Inc Medicare	$834.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,085.38

BIOMET FEMORAL STEM-CEMENTED

Facility IP

$5,567.94

Service Code	HCPCS C1776
Hospital Charge Code	40024002
Hospital Revenue Code	278
Min. Negotiated Rate	$2,783.97
Max. Negotiated Rate	$2,783.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,783.97
Rate for Payer: Hamaspik Choice Inc Medicare	$2,783.97

BIOMET FEMORAL STEM-CEMENTED

Facility OP

$5,567.94

Service Code	HCPCS C1776
Hospital Charge Code	40024002
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,846.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,062.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,783.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,201.57
Rate for Payer: Fidelis Medicare Advantage	$5,846.34
Rate for Payer: Group Health Inc Commercial	$2,783.97
Rate for Payer: Group Health Inc Medicare	$1,948.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,783.97
Rate for Payer: Hamaspik Choice Inc Medicare	$2,783.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,619.16

BIOMET FEMORAL STEM-NON CEMENTED

Facility IP

$12,462.66

Service Code	HCPCS C1776
Hospital Charge Code	40024003
Hospital Revenue Code	278
Min. Negotiated Rate	$6,231.33
Max. Negotiated Rate	$6,231.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,231.33
Rate for Payer: Hamaspik Choice Inc Medicare	$6,231.33

BIOMET FEMORAL STEM-NON CEMENTED

Facility OP

$12,462.66

Service Code	HCPCS C1776
Hospital Charge Code	40024003
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$13,085.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,854.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,231.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,166.03
Rate for Payer: Fidelis Medicare Advantage	$13,085.79
Rate for Payer: Group Health Inc Commercial	$6,231.33
Rate for Payer: Group Health Inc Medicare	$4,361.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,231.33
Rate for Payer: Hamaspik Choice Inc Medicare	$6,231.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,100.73

BIOMET HA CORT SCRW 150/30 L 6/5T

Facility OP

$512.50

Service Code	HCPCS C1713
Hospital Charge Code	40205828
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$538.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$281.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$256.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$294.69
Rate for Payer: Fidelis Medicare Advantage	$538.12
Rate for Payer: Group Health Inc Commercial	$256.25
Rate for Payer: Group Health Inc Medicare	$179.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.25
Rate for Payer: Hamaspik Choice Inc Medicare	$256.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$333.12

BIOMET HA CORT SCRW 150/30 L 6/5T

Facility IP

$512.50

Service Code	HCPCS C1713
Hospital Charge Code	40205828
Hospital Revenue Code	278
Min. Negotiated Rate	$256.25
Max. Negotiated Rate	$256.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.25
Rate for Payer: Hamaspik Choice Inc Medicare	$256.25

BIOMET JUGGER KNOT W/NEEDLE

Facility OP

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	40205315
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$577.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$302.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$275.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$316.25
Rate for Payer: Fidelis Medicare Advantage	$577.50
Rate for Payer: Group Health Inc Commercial	$275.00
Rate for Payer: Group Health Inc Medicare	$192.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$275.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$357.50

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